BACKGROUND Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studied. We hypothesized that long-term exposure of the lung donor and recipient to high levels of ambient air pollutants would increase the risk of PGD in lung transplant recipients. METHODS Using data from 1428 lung transplant recipients and their donors enrolled in the Lung Transplant Outcomes Group observational cohort study, we evaluated the association between the development of PGD and zip-code-based estimates of long-term exposure to 6 major air pollutants (ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, particulate matter 2.5, and particulate matter 10) in both the lung donor and the lung recipient. Exposure estimates used daily EPA air pollutant monitoring data and were based on the geographic centroid of each subject's residential zip code. Associations were tested in both univariable and multivariable models controlling for known PGD risk factors. RESULTS We did not find strong associations between air pollutant exposures in either the donor or the recipient and PGD. CONCLUSIONS Exposure to ambient air pollutants, at the levels observed in this study, may not be sufficiently harmful to prime the donor lung or the recipient to develop PGD, particularly when considering the robust associations with other established PGD risk factors.

中文翻译：

---

长期空气污染暴露和肺移植后原发性移植物功能障碍的风险。


背景 原发性移植物功能障碍 （PGD） 对肺移植术后的短期和长期死亡率都有很大影响，但导致 PGD 的机制尚不清楚。暴露于环境空气污染物与肺移植等待名单期间的不良事件和慢性肺同种异体移植物功能障碍有关，但其与 PGD 的相关性尚未得到研究。我们假设肺供体和受者长期暴露于高水平的环境空气污染物会增加肺移植受者患 PGD 的风险。方法 使用来自参加肺移植结果组观察队列研究的 1428 名肺移植受者及其供体的数据，我们评估了 PGD 的发展与基于邮政编码的长期暴露于 6 种主要空气污染物（臭氧、二氧化氮、二氧化硫、一氧化碳、颗粒物 2.5 和颗粒物 10）之间的关联肺供体和肺受者。暴露估计使用 EPA 的每日空气污染物监测数据，并基于每个受试者居住邮政编码的地理质心。在控制已知 PGD 危险因素的单变量和多变量模型中测试了关联。结果我们没有发现供体或受体的空气污染物暴露与 PGD 之间存在强关联。结论 暴露于本研究中观察到的水平的环境空气污染物可能不足以促使供体肺或受体患上 PGD，特别是当考虑到与其他已确定的 PGD 风险因素的强烈关联时。